Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,146.00 / $4,629.00 / $10,674.00	Facility		$1,146.00	$4,629.00	$10,674.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $826.81 / $974.71 / $1,709.76	Professional		$826.81	$974.71	$1,709.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,749.00 / $9,877.00 / $16,490.00	Facility		$4,749.00	$9,877.00	$16,490.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $687.16 / $898.25 / $2,122.60	Professional		$687.16	$898.25	$2,122.60
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,313.56 / $2,390.00 / $10,957.50	Facility		$1,313.56	$2,390.00	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,313.56 / $1,313.56 / $1,313.56	Professional		$1,313.56	$1,313.56	$1,313.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,035.32 / $1,035.32 / $1,035.32	Facility		$1,035.32	$1,035.32	$1,035.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $911.37 / $1,397.04 / $3,403.63	Professional		$911.37	$1,397.04	$3,403.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $981.04 / $2,420.64	Facility		$332.00	$981.04	$2,420.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $990.30 / $1,406.97 / $2,076.37	Professional		$990.30	$1,406.97	$2,076.37
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $850.41 / $850.41 / $850.41	Facility		$850.41	$850.41	$850.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $747.31 / $934.13 / $1,938.63	Professional		$747.31	$934.13	$1,938.63
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,035.32	Facility		$555.00	$597.00	$1,035.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $913.45 / $1,372.82 / $3,130.74	Professional		$913.45	$1,372.82	$3,130.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,248.00 / $11,200.00	Facility		$2,264.00	$5,248.00	$11,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $811.46 / $1,168.64 / $2,874.08	Professional		$811.46	$1,168.64	$2,874.08
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,098.98 / $1,098.98 / $4,641.09	Facility		$1,098.98	$1,098.98	$4,641.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $808.27 / $1,185.13 / $2,323.07	Professional		$808.27	$1,185.13	$2,323.07